Ovary, Intraoperative

Clinical Info:

  • Benign lesions are usually treated by simple oophorectomy.
  • Malignant lesions are usually treated by TAH, BSO, omentectomy, and periaortic node sampling.
  • Borderline lesions are treated depending on age and desire for preserved fertility.

Hints for Freezing Ovaries:

INK the external surfaces of ALL ovaries, regardless of benign or malignant appearance.

Gross Appearance Most Likely Diagnosis Approach to Freezing
Smooth-walled cyst with liquid or viscous contents Serous or Mucinous cystadenoma Representative wall
Cyst with thick bloody contents Endometriosis Representative wall
Cyst with hair, teeth, chalky material Teratoma (dermoid cyst) Representative wall, especially thickened or non-calcified solid areas (to look for immaturity)
Cyst with shaggy lining, papillary excrescences “Borderline” tumor or carcinoma Representative excrescences or solid area
Solid, cauliflower-like Carcinoma Representative viable, fleshy, solid area
Solid, fibrous Fibroma / Thecoma Representative section
Solid, fibrous with mucinous cysts Brenner tumor Representative junction between fibrous/cystic areas
Bilateral fibrous Metastatic carcinoma (any primary) Representative section
Bilateral mucinous Metastatic carcinoma (GI primary) Representative section

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